PERCUTANEOUS RELEASE OF TENNIS ELBOW: A SIMPLE TECHNIQUE.

Abstract

The aim of this study was to review the effectiveness of percutaneous release of the common extensor origin for tennis elbow. The operative technique is similar to that previously reported by Hohmann in 1949.

There were 29 patients (31 elbows) that underwent the procedure between 1991 and 1998. There were 14 males and 15 females; 19 were right handed, and 17 had the dominant arm involved. The mean age was 51.8 years (range 34–65); the mean duration of symptoms was 21.7 months (range 8–60 months). All patients had a minimum of 12 months of conservative treatment including NSAIDs, splinting, physical therapy and local anaesthetic and steroid injections (2–6 injections). All operations were performed as day case procedures, with the majority (25) done under local anaesthetic. 24 patients were independently reviewed using Hospital for Special Surgery Elbow Assessment and a questionnaire. Grip strength measurements were performed using JAMAR Dynanometer and the level of patient satisfaction was recorded.

5 patients could not attend the special review clinics. They were contacted over the phone and necessary data recorded. The mean follow up was 45.2 months (range 8–88 months). 24 patients scored above 70 points and were very satisfied, 6 patients were considered failures as their symptoms warranted formal open release operation; only two reported an improvement following the open releases, with the remainder still symptomatic at the last follow up. An overall success rate of 81% was recorded. Complications were rare - one patient who had bruising of forearm after the procedure.

In conclusion this procedure can be recommened as an efficacious first line of surgical treatment, with advantages of being safe, quick to perform and with minimal morbidity.